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Center for Workers with Disabilities. (n.d.) Overview of MBI for working individuals with disabilities. Washington, D.C.: Author.
Abstract
This overview of Medicaid Buy-In provisions reviews authorizing federal legislation, related work incentive provisions, and policy implications for states designing Buy-In programs. Features of Buy-In provisions related to financial eligibility, premiums, and cost sharing under the Balanced Budget Act of 1997 and the Ticket to Work and Work Incentives Improvement Act (TWWIIA) are reviewed and compared. Challenges for states include defining "employment" under their Buy-In programs in ways that do not conflict with federal law, meeting the maintenance-of-effort requirement of TWWIIA, and enabling individuals over age 64 (who can not participate in Buy-In programs under TWWIIA) to continue their Medicaid coverage while working or retaining their assets.
Other considerations for states include costs associated with Buy-In programs, the problem of SSDI recipients limiting their earnings to retain their cash benefits, and the contradiction between SSA eligibility standards for disability and work incentives such Buy-In provisions.
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